Laserfiche WebLink
AC"R®P CERTIFICATE OF LIABILITY INSURANCE <br />ATE (MMIDDNYYY) <br />P4/4/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Tina Cowie <br />NAME: <br />Cornerstone Specialty Insurance Services, Inc. <br />PHONE (714)731-7700 � N (714)731-7750 <br />EMAIL tincornerstone <br />s@conersones specialty. com <br />ADDRESS: p y <br />14252 Culver Drive, A299 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURERANatl Fire Ins. Co. of Hartford <br />20478 <br />Irvine CA 92604 <br />INSURED <br />INSURER B American Cas . Co. of Reading PA <br />20427 <br />INSURERC:Continental CasualtX CoLnpany <br />20443 <br />PROACTIVE CONSULTING GROUP, LLC <br />INSURER D <br />15235 Springdale St. <br />INSURER E <br />INSURER F : <br />Huntington Beach CA 92649 <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />I TYPE OF INSURANCE <br />ADOL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM D❑ <br />POLICY EXP <br />! DIMY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMAGE TO RENTED <br />PREMISES a occurr ce <br />$ 300 000 <br />X <br />VIED EXP(Any one person) <br />$ 10,000 <br />ADDT' L INSURED/PRIMARY <br />X <br />2084330890 <br />6/1/2016 <br />6/1/2017 <br />X <br />BLNKT WVR OF SUBRO <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />PER FORM #sB-300176-C <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY JPERO LOC <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />AS REQUzPMD BY WRITTEN <br />CONTRACT <br />PRODUCTS - COMPIOP AGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />A <br />X <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON-OWNED <br />H[REDAUTpS EXAUTOS <br />2084330890 <br />6/1/2016 <br />6/1/2017 <br />BODILY INJURY (Per accidert) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I RETENTION <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/ N <br />ANY PROPRIETOMPARTNEWEXECUTIVE <br />OFF[CFRlMEMBEB (Mandatory in NH) EXCLUtlEtl? <br />If yes, descrihe under <br />N )p` <br />Y <br />4024152345 <br />6/1/2016 <br />6/1/2017 <br />X PER <br />�RH <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />C <br />PROFESSIONAL 14IABILITY <br />ZEH288355962 <br />7/28/2016 <br />7/28/2017 <br />EACH CLAIM $1,000,000 <br />Claims Made <br />ANNUALAGGREGATE $1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: Environmental Compliance Consulting Services <br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional Insured <br />for General Liability but only if required by written contract with the Named Insured prior to an <br />occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. *30 <br />days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional <br />Liability coverage, the aggregate limit is the total insurance available for all covered claims reported <br />within the policy period. <br />CERTIFICATE HOLDER CANCELLATION <br />rrosas@santa-ana.org <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Water Resources Division <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attn: Rudy Rosas <br />AUTHORIZED REPRESENTATIVE <br />220 S. Daisy Avenue (M-85) <br />Santa Ana, CA <br />Tina Cowie/AZNIEEG <br />ACORD 25 (2014101) <br />I N S025 (2w4n 9 i <br />OO 1985-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />